Diabetes and the Risk of Multi-System Aging Phenotypes: A Systematic Review and Meta-Analysis

Background

Observational studies suggested an association between diabetes and the risk of various geriatric conditions (i.e., cognitive impairment, dementia, depression, mobility impairment, disability, falls, and urinary incontinence). However, the magnitude and impact of diabetes on older adults have not been reviewed.

Methodology/Principal Findings

MEDLINE and PSYCINFO databases were searched through November 2007 for published studies, supplemented by manual searches of bibliographies of key articles. Population-based, prospective cohort studies that reported risk of geriatric outcomes in relation to diabetes status at baseline were selected. Two authors independently extracted the data, including study population and follow-up duration, ascertainment of diabetes status at baseline, outcomes of interest and their ascertainment, adjusted covariates, measures of association, and brief results. Fifteen studies examined the association of DM with cognitive dysfunction. DM was associated with a faster decline in cognitive function among older adults. The pooled adjusted risk ratio (RR) for all dementia when persons with DM were compared to those without was 1.47 (95% CI, 1.25 to 1.73). Summary RRs for Alzheimer''s disease and vascular dementia comparing persons with DM to those without were 1.39 (CI, 1.16 to 1.66) and 2.38 (CI, 1.79 to 3.18), respectively. Four of 5 studies found significant association of DM with faster mobility decline and incident disability. Two studies examined the association of diabetes with falls in older women. Both found statistically significant associations. Insulin users had higher RR for recurrent falls. One study for urinary incontinence in older women found statistically significant associations. Two studies for depression did not suggest that DM was an independent predictor of incident depression.

Conclusions/Significance

Current evidence supports that DM is associated with increased risk for selected geriatric conditions. Clinicians should increase their awareness and provide appropriate care. Future research is required to elucidate the underlying pathological pathway.     

Calcium Increase in the Mammillary Bodies with Aging

To elucidate compositional changes of the mammillary body with aging, the authors investigated age-related changes of elements, relationships among their elements, and gender differences in the mammillary bodies by direct chemical analysis. After ordinary dissection at Nara Medical University was finished, the mammillary bodies were resected from the cerebra of the subjects. The subjects consisted of 19 men and 25 women, ranging in age from 70 to 101 years (average age?=?83.8?±?7.2 years). After ashing of the mammillary bodies with nitric acid and perchloric acid, element contents were determined by inductively coupled plasma–atomic emission spectrometry. It was found that the Ca content increased slightly and significantly in the mammillary bodies with aging, but the P, S, Mg, Zn, Fe, and Na contents did not change significantly with aging. Regarding the relationships among elements, significant correlations were found among the contents of Ca, P, S, and Mg in the mammillary bodies, with one exception between P and Mg contents. With regard to the seven element contents, no significant gender differences were found in the mammillary bodies.     

Calcium Oxalate Crystals in Monocotyledons: A Review of their Structure and Systematics

Three main types of calcium oxalate crystal occur in monocotyledons:raphides, styloids and druses, although intermediates are sometimesrecorded. The presence or absence of the different crystal typesmay represent ‘useful’ taxonomic characters. Forinstance, styloids are characteristic of some families of Asparagales,notably Iridaceae, where raphides are entirely absent. The presenceof styloids is therefore a synapomorphy for some families (e.g.Iridaceae) or groups of families (e.g. Philydraceae, Pontederiaceaeand Haemodoraceae). This paper reviews and presents new dataon the occurrence of these crystal types, with respect to currentsystematic investigations on the monocotyledons. Copyright 1999Annals of Botany Company Calcium oxalate, crystals, raphides, styloids, druses, monocotyledons, systematics, development.     

Calcium Nutrition and Resistance of Alfalfa to Ditylenchus dipsaci

Stem nematode-susceptible ''Atlantic'' and resistant ''Lahontan'' alfalfa seedlings, grown in sand and watered with complete nutrient solutions containing 0.75, 1.5, 3.0, 6.0, or 12.0 mM Ca⁺⁺/liter, were inoculated with Ditylenchus dipsaci (the stem nematode) 5-6 days after emergence. Approximately equal numbers of nematodes entered the tissues of each variety/Ca⁺⁺ concentration within 2 days. Penetration was reduced at 12 mM Ca⁺⁺/liter. Reproduction during 21 days following inoculation yielded 3-fold, or greater, nematode increases in ''Atlantic'' buds at all Ca⁺⁺ concentrations, in ''Atlantic'' cotyledons at the four lower concentrations, in ''Lahontan'' buds at the lowest concentration and in ''Lahontan'' cotyledons at the two lowest concentrations. Reproduction was lower at the higher Ca⁺⁺ concentrations.Increased nutrient Ca⁺⁺ concentrations resulted in increased Ca⁺⁺ content, decreased Na⁺ and K⁺ content, and unchanged Mg⁺⁺ content of buds and cotyledons. Accordingly, increased nutrient Ca⁺⁺ resulted in increased divalent/monovalent cation ratios (Ca⁺⁺ + Mg⁺⁺/Na⁺ + K⁺ ). Resistance to reproduction was correlated more closely with the divalent/monovalent cation ratio than with Ca⁺⁺ content of tissue, At the four higher nutrient Ca⁺⁺ concentrations, ''Lahontan'' buds had higher ratios than ''Atlantic,'' and infected buds had higher ratios than noninfected buds. Although cation balance modifies disease expression, the basic resistance mechanism remains unknown.     

Calcium as a Regulator of Intracellular Processes in Actinomycetes: A Review

Data on the effects of calcium ions (Ca²⁺) on processes of morphological and physiological differentiation in cultures of actinomycetes have been reviewed, with emphasis on representatives of the genus Strepomyces. Evidence accumulated thus far regarding the regulatory role of serine-threonine protein kinases in the differentiation and the possible involvement of Ca²⁺-dependent protein kinases in secondary metabolism (including antibiotic biosynthesis) are analyzed. The possibility that regulatory elements of apoptosis (including Ca²⁺-dependent) function in actinomycetes is discussed. A hypothesis is advanced, according to which determinants of antibiotic resistance play a key role in the network of signal transduction systems of actinomycetes.__________Translated from Prikladnaya Biokhimiya i Mikrobiologiya, Vol. 41, No. 4, 2005, pp. 363–375.Original Russian Text Copyright © 2005 by Danilenko, Mironov, Elizarov.     

High Accumulation of Calcium and Phosphorus in the Pineal Bodies with Aging

To elucidate compositional changes of the pineal body with aging, the authors investigated age-related changes of elements in the pineal body. After the ordinary dissection by medical students was finished, the pineal bodies and seven arteries were resected from the subjects ranging in age from 58 to 94 years. The element contents were determined by inductively coupled plasma atomic emission spectrometry. It was found that a high accumulation of Ca and P occurred in the pineal bodies with aging. Regarding the relationships among the elements, it was found that there were significant direct correlations among the contents of Ca, P, and Mg. With regard to the relationships between the pineal body and the arteries, no significant correlations were found in the Ca content between the pineal body and the arteries, such as the thoracic and abdominal aortas and the coronary, common carotid, pulmonary, splenic, and common iliac arteries.     

The Effect of Calcium Nutrition of Ethylene-induced Abscission

The influence of calcium nutrition on ethylene-induced abscission was studied by growing cotton (Gossypium hirsutum L. cv. Stoneville 213) and bean (Phaseolus vulgaris L. cv. Resistant Black Valentine) plants for several weeks in nutrient solutions containing 2, 10 (normal level), 15, or 20 meq/l of calcium, and then treating the plants with ethylene. Increasing the calcium level of cotton from 2 to 20 meq/l resulted in a 9-fold increase in the calcium content of the abscission zone and a maximum reduction of 25% in the amount of leaf abscission induced by ethylene (9 μl/l). Bean plants grown on 10, 15, or 20 meq/l calcium solutions showed corresponding increases in the calcium content of the abscission zone but showed no significant differences in the rate of ethyleneinduced abscission. Only at the lowest calcium level of 2 meq/l, where deficiency symptoms became apparent, was a significant effect observed. These results suggest that under normal cultural practices calcium nutrition has little influence on the rate of ethylene-induced abscission.     

Calcium Chloride in Neonatal Parenteral Nutrition: Compatibility Studies Using Laser Methodology

Introduction

We have previously reported results of precipitation studies for neonatal parenteral nutrition solutions containing calcium chloride and sodium phosphate using visual methods to determine compatibility. The purpose of this study was to do further testing of compatibility for solutions containing calcium chloride using more sensitive methods.

Methods

Solutions of Trophamine (Braun Medical Inc, Irvine, CA) and Premasol (Baxter Pharmaceuticals, Deerfield, IL) were compounded with calcium chloride and potassium phosphate. Controls contained no calcium or phosphate. After incubation at 37° for 24 hours solutions without visual precipitation were analyzed to determine mean particle size using dynamic light scattering from a laser light source.

Results

Particle sizes were similar for control solutions and those without visual precipitation and a mean particle size <1000 nm. Compatible solutions were defined as those with added calcium and phosphate with no visual evidence of precipitation and mean particle size <1000 nm. In solutions containing 2.5–3% amino acids and 10 mmol/L of calcium chloride the maximum amount of potassium phosphate that was compatible was 7.5 mmol/L.

Conclusion

Maximum amounts of phosphate that could be added to parenteral nutrition solutions containing Trophamine and calcium chloride were about 7.5–10 mmol/L less for a given concentration of calcium based upon laser methodology compared to visual techniques to determine compatibility. There were minor differences in compatibility when adding calcium chloride and potassium phosphate to Premasol versus Trophamine.     

The Effect of Calcium Sodium Phosphosilicate on Dentin Hypersensitivity: A Systematic Review and Meta-Analysis

Objective

To investigate the effect of calcium sodium phosphosilicate (CSPS) in treating dentin hypersensitivity (DH) and to compare this effect to that of a negative (placebo) control.

Materials and Methods

Several databases, including Medline, EMBASE, Web of Science, The Cochrane Library, and the Chinese Biomedical Literature Database, were searched to identify relevant articles published through January 2015; grey literature (i.e., academic literature that is not formally published) was also searched. Two authors performed data extraction independently and jointly using data collection forms. The primary outcome was the DH pain response to routine activities or to thermal, tactile, evaporative, or electrical stimuli, and the secondary outcome was the side effects of CSPS use. Each study was evaluated using the Cochrane Collaboration tool for assessing risk bias. Meta-analysis of studies with the same participant demographics, interventions, controls, assessment methods and follow-up periods was performed. The Grading of Recommendations Assessment Development and Evaluation System was used to assess the quality of the evidence and the risk of bias across studies.

Results

Meta-analysis demonstrated that toothpaste containing 5% CSPS was more effective than the negative control at relieving dentin sensitivity, with the level of evidence classified as “moderate”. In addition, prophylaxis paste containing 15% calcium sodium phosphosilicate was favored over the negative control at reducing post-periodontal therapy hypersensitivity, with the level of evidence categorized as “low”. Only two studies reported side effects of CSPS use.

Conclusions

The majority of studies found that calcium sodium phosphosilicate was more effective than the negative control at alleviating DH. Because strong evidence is scarce, high-quality, well-designed clinical trials are required in the future before definitive recommendations can be made.     

Sampling Plan Optimization: A Data Review and Sampling Frequency Evaluation Process

Lawrence Livermore National Laboratory (LLNL) uses a cost-effective sampling (CES) methodology to evaluate and review ground water contaminant data and optimize the site's ground water monitoring plan. The CES methodology is part of LLNL's regulatory approved compliance monitoring plan (Lamarre et al., 1996). It allows LLNL to adjust the ground water sampling plan every quarter in response to changing conditions at the site. Since the use of the CES methodology has been approved by the appropriate regulatory agencies, such adjustments do not need additional regulatory approval. This permits LLNL to respond more quickly to changing conditions. The CES methodology bases the sampling frequency for each location on trend, variability, and magnitude statistics describing the contaminants at that location, and on the input of the technical staff (hydrologists, chemists, statisticians, and project leaders). After initial setup is complete, each application of CES takes only a few days for as many as 400 wells. Effective use of the CES methodology requires sufficient data, an understanding of contaminant transport at the site, and an adequate number of monitoring wells downgradient of the contamination. The initial implementation of CES at LLNL in 1992 produced a 40% reduction in the required number of annual routine ground water samples at LLNL. This has saved LLNL $390,000 annually in sampling, analysis, and data management costs.     

Sampling Plan Optimization: A Data Review and Sampling Frequency Evaluation Process

Lawrence Livermore National Laboratory (LLNL) uses a cost-effective sampling (CES) methodology to evaluate and review ground water contaminant data and optimize the site's ground water monitoring plan. The CES methodology is part of LLNL's regulatory approved compliance monitoring plan (Lamarre et al., 1996 Lamarre, A. L., Nichols, E. M., Berg, L. L., Dresen, M. D., Gelinas, R. J., Bainer, R. W. and Folsom, E. N. 1996. Compliance monitoring plan for the Lawrence Livermore National Laboratory Livermore Site UCRL-AR-120936 [Google Scholar]). It allows LLNL to adjust the ground water sampling plan every quarter in response to changing conditions at the site. Since the use of the CES methodology has been approved by the appropriate regulatory agencies, such adjustments do not need additional regulatory approval. This permits LLNL to respond more quickly to changing conditions. The CES methodology bases the sampling frequency for each location on trend, variability, and magnitude statistics describing the contaminants at that location, and on the input of the technical staff (hydrologists, chemists, statisticians, and project leaders). After initial setup is complete, each application of CES takes only a few days for as many as 400 wells. Effective use of the CES methodology requires sufficient data, an understanding of contaminant transport at the site, and an adequate number of monitoring wells downgradient of the contamination. The initial implementation of CES at LLNL in 1992 produced a 40% reduction in the required number of annual routine ground water samples at LLNL. This has saved LLNL $390,000 annually in sampling, analysis, and data management costs.     

Biomediated Precipitation of Calcium Carbonate Metastable Phases in Hypogean Environments: A Short Review

Natural precipitates of metastable polymorphs of CaCO 3 , such as vaterite, are rarely found in nature however, they have been widely synthesized in laboratory under particular conditions (ie, supersaturated solutions, relative high temperatures, etc.). By SEM and XRD we recognize vaterite spherulites from culturable microbial colonies isolated from hypogean environments. Spherical bodies (∽10μin diameter), probably composed of vaterite, occur in submilimetric microbial mats and biofilms on volcanic substrates (Saint Callixtus Catacombs, Rome, Italy) and karstic caves (Altamira, Candamo, and Tito Bustillo caves, Spain, and Grotta dei Cervi, Italy) where cyanobacteria and actinomycetes are the major microbial components. These particles form beneath dense biofilms, where particular physicochemical conditions are developed by the microbial activity. Natural biofilms seems to generate microenvironments favoring the formation and preservation of metastable CaCO 3 polymorphs. This also shows a major role of microbes in processes of low-temperature alteration of different hypogean rock-substrates.     

Moderate Accumulation of Calcium and Phosphorus in the Splenic Artery with Aging and Low Accumulation of Those in the Pulmonary Artery with Aging

To elucidate compositional changes of the arteries with aging, the authors investigated age-related changes of elements in the splenic and pulmonary arteries, which supplied blood to contractile organs. After ordinary dissection by medical students at Nara Medical University was finished, the splenic and pulmonary arteries were resected from the subjects, ranging in age from 58 to 94 years. The element contents were determined by inductively coupled plasma-atomic emission spectrometry. It was found that a moderate accumulation of Ca and P occurred in the splenic artery with aging, but it hardly occurred in the pulmonary artery with aging. Regarding the relationship among elements, the finding that there were significant direct correlations among the contents of Ca, P, Mg, and Na was commonly obtained in both the splenic and pulmonary arteries. The accumulation of Ca and P in the splenic artery with aging occurred independently of that in the pulmonary artery. Histologic observation indicated that a major part of Ca deposits was seen in the middle tunica, but not in the internal tunica. Therefore, the calcification occurring in the splenic artery belonged to middle sclerosis.